A - 05 Insight and Anxiety Ratings as Predictors of Mild Cognitive Impairment and Dementia.

Abstract

Insight has been investigated as a predictor of mood symptoms and psychosis onset. Little research has examined insight as a predictor of diagnosis, especially given possible confounding factors such as anxiety. This cross-sectional study included 223 adult patients diagnosed with Mild Cognitive Impairment (MCI) or Dementia as a result of outpatient neuropsychological evaluation. Patients completed either the Depression Anxiety Stress Scale (DASS-42) or the Beck Anxiety Inventory (BAI) and the Behavioral Dyscontrol Scale (BDS-II). Participants were divided into four groups (MCI, Dementia, MCI + Anxiety, or Dementia+Anxiety) utilizing DASS-42 anxiety scale ≥7, or BAI score ≥ 7 (clinical anxiety). Insight grouping (four categories: 0 [no insight] to 3 [intact insight]) was determined by the BDS-II clinician-based insight rating. Diagnosis and insight groups were compared using one-way ANOVAs. Predictive value of BDS-II insight scores was determined by logistic regression. The sample was 52.9% male and 87.9% non-Hispanic White, with mean age 75.54 (SD = 8.24) and education 16.1years (SD = 2.9). There was a significant difference between diagnoses and insight levels for the four conditions [F(3, 219) = 6.06, p < 0.001]. The logistic regression model was significant [χ2(9, N = 223) = 25.79, p < 0.01]. The model explained 11.9% of the variance in diagnosis and correctly identified 47.1% of the cases. Insight appears to affect the diagnostic outcomes in cases of MCI and dementia. Clinicians should consider insight ratings, along with clinical history, behavioral observations, and test findings when evaluating possible MCI and dementia. Future research should examine neurocognitive disorder subtypes to identify those most affected by reduced insight.